Clinical accuracy of a non-contact infrared skin thermometer in paediatric practice.

BACKGROUND: Rectal thermometry is considered the most reliable method for measuring the temperature in the paediatric population. Recently, a new non-contact skin infrared thermometer for children was introduced in the market with excellent acceptance by parents. METHODS: A prospective, analytical, cross-sectional study was designed in order to assess the effectiveness of the infrared non-contact thermometer (Thermofocus) in comparison with two other known methods used to measure body temperature. Children aged 1 to 48 months were included from the emergency room and inpatient unit. All patients selected were assessed with three different thermometers: (1) non-contact infrared thermometer (Thermofocus); (2) temporal artery thermometer (Exergen); and (3) rectal glass mercury thermometer. RESULTS: Four hundred and thirty-four patients were eligible to complete the study. One hundred and sixty-seven were identified with fever. The mean age of the patients studied was 14.6 ± 10.7 months. Both devices were strongly correlated with the rectal temperature: r = 0.950 for Exergen and r = 0.952 for Thermofocus. The mean difference in temperature between the rectal temperature and the non-contact thermometer was 0.029 ± 0.01 °C (P < 0.001), while the mean difference between the temporal artery thermometer and the rectal temperature was -0.20 ± 0.27 °C (P < 0.001). The sensitivity and specificity for the non-contact thermometer is 97%. The negative predictive value is 99%, which is especially important to rule out fever and avoid unnecessary laboratory work-up. CONCLUSIONS: The non-contact infrared thermometer is a reliable, comfortable and accurate option for measurement of temperature and is very useful for the screening of fever in the paediatric population. More studies are recommended to support the evidence found in this study and compare its accuracy with more complex devices.

Prevalence of insulin resistance and its association with metabolic syndrome criteria among Bolivian children and adolescents with obesity.

BACKGROUND: Obesity is a one of the most common nutritional disorder worldwide, clearly associated with the metabolic syndrome, condition with implications for the development of many chronic diseases. In the poorest countries of Latin America, malnourishment is still the most prevalent nutritional problem, but obesity is emerging in alarming rates over the last 10 years without a predictable association with metabolic syndrome. The objective of our study was to determine the association between insulin-resistance and components of the metabolic syndrome in a group of Bolivian obese children and adolescents. The second objective was determining the relation of acanthosis nigricans and insulin-resistance. METHODS: We studied 61 obese children and adolescents aged between 5 and 18 years old. All children underwent an oral glucose tolerance test and fasting blood sample was also obtained to measure insulin, HDL, LDL and triglycerides serum level. The diagnosis of metabolic syndrome was defined according to National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) criteria adapted for children. RESULTS: Metabolic syndrome was found in 36% of the children, with a higher rate among males (40%) than females (32.2%) (p = 0.599). The prevalence of each of the components was 8.2% in impaired glucose tolerance, 42.6% for high triglyceride level, 55.7% for low levels of high-density lipoprotein cholesterol, and 24.5% for high blood pressure. Insulin resistance (HOMA-IR > 3.5) was found in 39.4% of the children, with a higher rate in males (50%) than females (29%). A strong correlation was found between insulin resistance and high blood pressure (p = 0.0148) and high triglycerides (p = 0.002). No statistical significance was found between the presence of acanthosis nigricans and insulin resistance. CONCLUSION: Metabolic syndrome has a prevalence of 36% in children and adolescent population in the study. Insulin resistance was very common among children with obesity with a significant association with high blood pressure and high triglycerides presence.